From the Guidelines
For abscess drainage on the thigh, Interventional Radiology (IR) is generally preferred over General Surgery (Gen Surg) due to its minimally invasive nature and lower risk of complications, as supported by the high clinical success rates and low complications reported in the literature 1.
Key Considerations
- IR-guided drainage can be performed under local anesthesia and typically involves the insertion of a small catheter to drain the abscess.
- The choice of IR over Gen Surg is based on the lower associated morbidity and mortality of radiologic management compared to open surgical drainage (OSD) 1.
- Some cases may require consideration of alternative therapies, such as endoscopic or laparoscopic approaches, depending on physiologic and anatomic factors.
Procedure Details
- Antibiotics may be administered to prevent infection, and the catheter is usually left in place until drainage is less than a certain threshold per 24 hours to ensure complete abscess resolution.
- Regular follow-up with imaging is necessary to monitor the abscess size and catheter placement, allowing for adjustments to the treatment plan as needed.
From the Research
Comparison of Interventional Radiology (IR) and General Surgery (Gen Surg) for Abscess Drainage on the Thigh
- The study 2 from 1987 describes the use of sonography for the detection, diagnosis, and drainage of thigh abscesses, with successful percutaneous catheter drainage in all 18 patients, including those who had previously undergone unsuccessful ward aspiration or formal surgery.
- In contrast, there is limited direct comparison between IR and Gen Surg for abscess drainage on the thigh in the provided studies.
- However, the study 3 from 2020 highlights the role of IR in the management of localized infections, including abscess drainage, and suggests that IR procedures can be a viable alternative to surgical options in certain cases.
- The study 4 from 2019 discusses the basics of interventional radiology procedures, including image-guided fine-needle aspiration cytology and biopsy, tru-cut (core) biopsy, needle aspiration/drainage, and percutaneous catheter drainage, which can be used for abscess drainage.
- The study 5 from 2022 presents a case report of minimally invasive percutaneous ultrasound-guided drainage of a tuberculous iliopsoas abscess in an immunocompromised patient, demonstrating the effectiveness of IR in treating complex abdominal pathologies.
- The study 6 from 2016 evaluates the safety and efficacy of percutaneous transgluteal drainage of pelvic abscesses using a CT-guided approach, finding it to be a safe and effective alternative to surgery.
Key Points
- IR procedures, such as percutaneous catheter drainage, can be effective in treating thigh abscesses 2.
- IR can be a viable alternative to surgical options for abscess drainage in certain cases 3.
- Basic interventional radiology procedures, including image-guided drainage, can be used for abscess drainage 4.
- Minimally invasive IR procedures can be effective in treating complex abdominal pathologies, including abscesses 5.
- Percutaneous CT-guided drainage with a transgluteal approach can be a safe and effective alternative to surgery for deep pelvic abscesses 6.